Stents and bypass surgery are no more effective than drugs for stable heart disease,

[Yo_Mama_Been_Loggin]

highly anticipated trial results show

Some of the most common invasive heart procedures in America are no better at preventing heart attacks and death in patients with stable heart disease than pills and lifestyle improvements alone, according to a massive federally funded study designed to resolve a long-standing controversy in cardiology.

Researchers found that invasive procedures to unclog blocked arteries — in most cases, the insertion of a stent, a tiny mesh tube that props open a blood vessel after artery-clearing angioplasty — were measurably better than pills at reducing patients’ chest pain during exercise. But the study, called ISCHEMIA, found no difference in a constellation of major heart-disease outcomes, including cardiac death, heart attacks, heart-related hospitalizations and resuscitation after cardiac arrest. There was no benefit to an invasive strategy in people without chest pain.

Overall, the keenly anticipated ISCHEMIA study results suggest that invasive procedures, stents and bypass surgery, should be used more sparingly in patients with stable heart disease and the decision to use them should be less rushed, experts said.

The $100 million trial, presented Saturday at the annual meeting of the American Heart Association ahead of publication in a peer-reviewed journal, is the latest entry into a long and contentious argument over how to treat artery blockages, one that has pitted powerful factions of American heart specialists against each other. It echoes a similar study 12 years ago that was critiqued by interventional cardiologists, the doctors performing the invasive procedures.

https://www.washingtonpost.com/health/2019/11/16/embargoed-drugs-are-effective-invasive-procedures-patients-with-stable-heart-disease-major-trial-finds/?wpisrc=al_news__alert-hse--alert-national&wpmk=1

[SWBTATTReg]

1. Thanks for providing information. Have a vested interest in. Take care! NT

[Cirque du So-What]

2. Interventional cardiologists disagree? What a shocker!

[oregonjen]

3. What kind of drugs and how do they affect other organs, like kidneys?

Last edited Sat Nov 16, 2019, 09:47 PM - Edit history (1)

My late bestie, my dog, had mitral valve disease. Drugs kept his heart fine, but hurt his kidneys. He ended up with kidney failure, which took his life. Wonder how powerful human drugs are and what issues come up from taking them.

[Xipe Totec]

4. +1, and what's the lifetime cost of drugs vs the cost of inserting stent once? nt

[Stuart G]

5. Thank You Very Much for this article and the link..K and R

[Grasswire2]

6. top cardiologist Dr. Sinatra advises AGAINST stents in some circumstances.

[link:https://www.drsinatra.com/is-an-angioplasty-procedure-best-for-you|


Likely Candidates for an Angioplasty Procedure

Continue to have physical symptoms that are interfering with the quality of your life despite conventional and alternative therapies. Some of these symptoms include chest discomfort, shortness of breath and feeling profoundly weak upon exertion.

Have symptoms along with stenosis (when disease causes blockage in a major blood vessel that supplies blood to a large area of the heart and feeds many blood vessels).

Have had a recent heart attack and a positive nuclear treadmill test with profound EKG changes—with or without symptoms—showing your heart is at risk of further injury.

In less complicated terms, an angioplasty–stent procedure is warranted for patients showing signs of a heart attack or advancing unstable coronary disease. In the case of acute coronary artery syndrome (pre-infarction angina) or a heart attack especially, the angioplasty procedure should be done immediately and can be a real lifesaver.

However, if your disease is stable and you're totally asymptomatic, I would advise against the angioplasty procedure. A study published in the New England Journal of Medicine showed that patients who had angioplasty–stent procedures and took drugs to treat their coronary artery disease had the same risk of future cardiovascular events as the patients who only took the drugs.

It’s clear to me in this situation that the risk associated with the angioplasty procedure isn’t worth the potential reward. You will be much better off making lifestyle changes that support cardiac health.